| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Select Health
| Professional | $120.23 | $120.23 | $120.23 |
SurFactor or NuDyn, per 0.5 cc
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5,128.61 | $5,128.61 | $5,128.61 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
Select Health
| Professional | $120.23 | $120.23 | $120.23 |